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L4-L5 protrusion without sciatic pain; pain increases after any exercise

scouteesscoutee Posts: 1
edited 12/23/2014 - 9:43 AM in Lower Back Pain
Hi all, looking for other folks who have a similar pain profile who may be able to help me understand what's causing my pain, and how to manage it better.

Quick background: I've dealt with on/off sciatic pain down left thigh for about 10 years (since age 23). I've thrown my back out 4-5 times in those 10 years; each time I used ice/heat and muscle relaxants (flexiril) which had me feeling better in a few weeks. 5 years ago I started weight lifting and I believe that increasing my overall strength and core strength improved my back - I only threw out my back once in those 5 years. Except... In June of this year I threw my back out. I changed over to walking for exercise (often helpful for sciatic pain) and laid off the weights for a few weeks. In August I realized that every time I tried to exercise (even walking!), my back would flare up, which is problematic as exercise is how I manage my ongoing, treatment-resistant depression (unrelated). I saw a PT in early Sept. he gave me exercises which I did faithfully for 2 months with no improvement. During this time I also started going to yoga 2-3 times per week in addition to my regular (but now very light) weight lifting exercises, which I modified with advice from PT so as to not aggravate my back. Mid-October I guess I overdid it by weight lifting 5x that week and doing yoga 3x (usually I kept it down to a total of about 5 sessions per week)... and ever since that time, I no longer feel any sciatic pain AT ALL, but my low back pain is constant and increases without fail after exercise (although it doesn't feel any worse than normal while I exercise, which is limited to walking, non-rotational stretches, plank holds, and other back-friendly yoga positions).

I had an MRI in early December which showed a "protruding" left eccentric disc at L4-L5 (causing stenosis in the neural foramin and lateral recess), plus a "sizeable annular tear" in the same disc. I also have bulges at L3-L4 and L5-S1, and facet hypertrophy at L3-L4. These seem like the most important findings. The orthopedist I saw (PA not a Dr) did not review my MRI results with me, nor did she seem to listen to me when I said my main concern was the constant low back pain - she insisted that the L4-L5 disc would cause the sciatic pain I had been feeling, and brushed off the low back pain saying it was certainly due to the L4-L5 protrusion. After listening to all the things I tried to alleviate my pain, she said the next thing I could try is an ESI. She sent me home with 15mg Mobic/meloxicam, which I have been taking every day since and seems to help a little (daily pain is down to a 1/2 instead of a 3/4 - although exercise makes it a 3/4 if not higher). I had an interlaminar ESI last Thursday, but I'm feeling no relief from it. My back feels exactly the same, and the light exercise I've done since has predictably increased my pain every time.

I have a follow-up with the orthopedist next Friday - I will make sure I see a doctor instead of the PA, and I will ask him to review my MRI results with me so I can ask him questions. And if I don't like the doctor, I'll definitely go to a different place for a 2nd opinion - not too impressed with the quality of care from this place so far.

In the meantime, I'm wondering if anyone else has similar localized low back pain that is unrelenting (literally constant), and if so, have you found methods to manage that pain that allows you to remain active? Does anyone else have this constant low back pain that does not radiate and gets worse after exercise (but doesn't hurt worse during exercise)?

P.S. I know that my symptoms are not nearly as severe as many folks on this board deal with every day. I am grateful that I have my mobility, and I appreciate that it could be much worse. But depression has nearly killed me several times before so I know it's a life-threatening disease, and right now it's one that my back issues are preventing me from treating effectively, which is terrifying me.


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